Download Asthma and COPD Prescriber Questions August

August 2012
Asthma and COPD
1.
Q:
What are the triggers of asthma?
A:
1. Exercise
2. Infection
3. Allergens: seasonal and pets
4. Irritants: pollution
5. Cold air
6. Medication
7. Emotional stress
8. Foods
2.
Q:
How often are asthma medications to be reviewed?
A:
Every 3 to 6 months.
3.
Q:
What is the cornerstone of asthma management?
A:
Inhaled therapy that maximizes delivery of drugs to the respiratory tract and minimizes systemic
side effects.
4.
Q:
What are the methods of delivering asthma medications?
A:
1.
Metered dose inhalers (pMDI) with spacers
2.
Dry powder inhalers (DPI)
3.
Nebulized therapy
5.
Q:
Which delivery method is the most effective?
A:
They are all equally effective.
6.
Q:
Name the two classes of asthma medications:
A:
1.
Bronchodilators 2. Anti-inflammatory agents
7.
Q:
What are the classes of bronchodilator medications for asthma?
A:
1.
Short Acting Inhaled Beta Agonists (SABA)
2.
Long-acting Inhaled Beta Agonists (LABA)
3.
Anticholinergic Agents
4.
Theophylline Products
8.
Q:
Name common SABA medications.
A:
1.
Salbutamol 2.
Terbutaline
9.
Q:
What are the SABA medications used to treat?
A:
1.
Acute exacerbation 2.Prevent exercise induced asthma
10.
Q:
What is the dosing schedule for SABA?
A:
PRN
11.
Q:
What is the use limit for SABA? Then do what?
A:
If using a SABA > 4x Q Wk then add an anti-inflammatory medication.
12.
Q:
Name common LABA medications.
A:
1.
Salmeterol 2.
Formoterol
13.
Q:
What is the dosing schedule for LABA in the treatment of asthma?
A:
Twice daily
14.
Q:
Which LABA has a rapid onset and may be used for rescue therapy?
A:
Formoterol
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How are LABA medications to be dosed, alone or in combination?
LABA are to be used only when inhaled corticosteroids are already in use.
Describe a major use of LABA medications.
Exercise induced bronchospasm.
Name the Anticholinergic Agents used to treat asthma.
1.
Ipratropium
2. Tiotropium
What are the uses of Ipratropium?
1.
As an alternative to Beta Agonists that cause tremor or tachycardia
2.
Longer acting broncho dilation than Beta Agonists
3.
Useful for beta-blocker induced bronchospasm
How is Tiatropium used that is different from Ipratropium?
1.
QD admin rather than TID to QID
2.
Used as maintenance rather than acute care.
Name the anti-inflammatory agents used to treat asthma.
1.
Inhaled corticosteroids 2. Systemic corticosteroids
3.
Leukotriene Receptor Antagonists (LTRAs)
Name the inhaled corticosteroid medications.
1.
Beclomethasone 2. Budesonide 3. Ciclesonide 4. Fluticasone
What are two common inhaled corticosteroid and LABA medications?
1.
Salmeterol with Fluticasone 2.
Budesonide with Formoterol
What is the best dosing schedule for inhaled corticosteroid medications?
On a regular schedule at the lowest effective dose.
What is the most common topical side effect of inhaled corticosteroid use?
Pharyngeal candidiasis.
What can be done to reduce pharyngeal candidiasis?
Rinse mouth after dosing or use a spacer device.
What are the asthma treatment uses of systemic corticosteroids?
1.
Asthma prevention 2.
Acute asthma exacerbations
What medications are in the class of Leukotriene Receptor Antagonists?
1.
Zafirlucast 2.
Montelukast
What is the initial drug strategy for COPD?
1.
SABA PRN 2.
Supplement with long acting bronchodilators.
What additional medications may be needed for COPD?
Maximum bronchodilation may require a combination of
LABA and anticholinergic medications
What medications are used in acute exacerbations of COPD?
A combination of SABA and Ipratropium
Theophylline may be used for extreme COPD, with what major cautions?
Drug interactions due to stopping smoking and clarithromycin use.
What are the most common infectious agents in COPD exacerbations?
Viral
What are the most common bacterial infectious agents causing acute
exacerbations in COPD? A: 1.
Strep pneumonia 2. H.flu 3.
Moraxella